Saturday, November 20, 2010

Bedtime blues

Does your child often wet the bed? This common problem can be helped

It’s proper name is nocturnal enuresis, but most parents know it as bed-wetting – a problem for many children and their families.
Parents often become concerned about bed-wetting when they believe their son or daughter is “old” enough to control the problem.
But the fact is, there is no set age as to when bed-wetting should end.
Most bed-wetters have little or no psychological problems that could contribute to the condition, but the act itself can cause great embarrassment and distress for your child.
The good news is for many children, this problem can be fixed by simple methods.
The causes of bed-wetting are not known but generally children who persistently wet the bed have difficulty waking up to go to the toilet when their bladder is full.
Sometimes their bladder is smaller or “irritable” and holds less urine or sometimes they are just heavy sleepers and their brain doesn’t respond to signals that their bladder is full.
Strange as it seems, bed-wetting does appear to run in families, so if the parents were bed-wetters when they were children, it’s likely their children will also have the problem.
It is also common that children may stop wetting the bed at some stage, but develop the problem again later on.
At four years of age, nearly one in three children will wet the bed on a regular basis but this statistic drops to about one in 10 by the age of six and one in 20 by the age of 10. It is also more common in boys than girls.
The Royal Children’s Hospital in Melbourne has published a great fact sheet on bed-wetting.
It says recent research has found that many children who wet the bed produce less of a hormone known as antidiuretic hormone (ADH) during sleep. This hormone normally reduces urine production during sleep.
These children produce more urine during the hours of sleep than their bladders can hold. If they do not wake up, the bladder releases the urine and the child wets the bed.
Treating bed-wetting involves patience, encouragement and understanding.
Punishing or making fun of the child will only make things worse, so make sure other siblings do not tease their bed-wetting brother or sister.
For treatment to work, your child needs to be involved. There will be good and bad days, but try not to be negative.
Teach them everything there is to know about bed-wetting, so they understand what’s happening and that they are not alone – chances are some of their friends have the same problem.
Here are some tips that may help:
* Make sure your child drinks plenty of water throughout the day. Don’t ever restrict the amount they drink as this will not help and can even delay the process of getting them to stop bed-wetting. Try to make it routine to go to the toilet before bedtime.
* Rewards are not usually necessary as the reward of waking up dry is a good incentive. Surprise them with a treat when they do have a dry night instead. Don’t allow them to be disappointed when they don’t get a reward due to bed-wetting.
* Try using a chart of wet and dry nights. Get your child to help you make it and choose the stickers or pictures. Charts, in combination with other methods, can help encourage your child.
* If you are putting your child in a nappy at night to save on washing bed linen, your child is unlikely to have dry nights. It is better to do away with the nappy for a week every couple of months.
* Be sure to use a mattress protector. There are different types available to protect the bed and pillow.
* Another method to try is a bed-wetting alarm. Research has shown 80 per cent of children who use an alarm have success in stopping bed-wetting but it may take up to eight weeks to work. Mattress bed-wetting alarms consist of a rubber mat connected by a wire to a box with a battery powered alarm bell that goes off when the mattress gets wet. It operates at low voltage so does not pose a risk to your child. You do need to help your child understand what it is and how it works, so do a few practice runs first during the day. When the alarm goes off, your child needs to learn to run straight to the toilet to finish emptying their bladder.
* Bladder training is another method that may help but must be undertaken with the advice of your doctor as it is not suitable for every child. It involves teaching your child to “hold on” when their bladder is full. This training may help increase their overnight bladder capacity.
* In some cases, there may be a physical problem causing the child’s bed-wetting. Most children who wet the bed do not need to take medication, but there are occasions when it can be useful and you would need to speak to your doctor.


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